246 episodes

Expert insight on health, performance, longevity, critical thinking, and pursuing excellence. Dr. Peter Attia (Stanford/Hopkins/NIH-trained MD) talks with leaders in their fields.

The Peter Attia Drive Peter Attia, MD

    • Health & Fitness
    • 5.0 • 2 Ratings

Expert insight on health, performance, longevity, critical thinking, and pursuing excellence. Dr. Peter Attia (Stanford/Hopkins/NIH-trained MD) talks with leaders in their fields.

    AMA #35: "Anti-Aging" Drugs — NAD+, metformin, & rapamycin

    AMA #35: "Anti-Aging" Drugs — NAD+, metformin, & rapamycin

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    In this “Ask Me Anything” (AMA) episode, Peter is joined by special guest, Dr. Matt Kaeberlein. Together they answer many questions around the field of aging with an emphasis on three specific molecules—NAD, metformin, and rapamycin—and their purported geroprotective qualities. They first discuss aging biomarkers and epigenetic clocks before breaking down the advantages and limitations of the most common experimental models being used today to study aging and pharmacological possibilities for extending lifespan. Next they dive deep into NAD and the much-hyped NAD precursors, nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN). They compare data from NAD precursors to studies on metformin and rapamycin, assessing how they stack up against each other and using the comparison as an opportunity to illustrate how to make sense of new experimental data and make smart decisions about how to approach future research.
    If you’re not a subscriber and listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or on our website at the AMA #35 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.
    We discuss:
    Logic behind comparing NAD precursors to rapamycin and metformin [3:40]; Aging biomarkers: current state, usefulness, and future promise [7:00]; Epigenetic clocks: definition, use case, and limitations [14:45];   Advantages and limitations of studying aging in non-humans and the strengths and weaknesses of different model systems [26:30]; Aging studies: importance of control lifespans and the problems with reproducibility [34:15]; Intro to NAD, potential role in aging, relationship to sirtuins, and more [48:15]; NAD precursors (NR and NMN): current data [1:10:00]; Human studies with NAD precursors [1:25:45]; Comparing NAD lifespan data to data from metformin and rapamycin [1:28:30]; Defining a “clean drug” and a “dirty drug” [1:38:00]; Reason for the lack of rapamycin studies in humans compared to NAD and metformin [1:41:00]; Ranking the geroprotective molecules in terms of risk and reward [1:48:00]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
     

    • 30 min
    Exercising for longevity: strength, stability, zone 2, zone 5, and more

    Exercising for longevity: strength, stability, zone 2, zone 5, and more

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    In this special episode of The Drive, we have pulled together a variety of clips from previous podcasts about exercise to help listeners understand this topic more deeply, as well as to identify previous episodes which may be of interest. In this episode, Peter discusses his framework for exercise, what he’s really optimizing for, and how to train today to be prepared for a good life at age 100. He describes the importance of strength and stability, and why deadlifting is an important tool to consider for longevity. Additionally, he details why training in zone 2 and zone 5 is important, gives a primer on VO2 max, and describes the most effective ways to engage in those types of exercise. Finally, Peter reveals his current exercise routine.
    We discuss:
    What is Peter optimizing for with his exercise? [3:00]; Preparing for a good life at age 100: Training for the “Centenarian Olympics” [6:00]; The importance of preserving strength and muscle mass as we age [21:45]; The value of deadlifts for stability and longevity when done properly [27:30]; The importance of zone 2 aerobic training [35:45]; The most effective ways to engage in zone 2 exercise [40:00]; Zone 5 training and VO2 max [44:15]; A primer on VO2 max [52:00]; Stability—the cornerstone upon which all exercise and movement relies [1:03:00]; Peter’s current exercise routine [1:07:45]; More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

    • 1 hr 14 min
    Energy balance, nutrition, & building muscle | Layne Norton, Ph.D. (Pt.2)

    Energy balance, nutrition, & building muscle | Layne Norton, Ph.D. (Pt.2)

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    Layne Norton holds a Ph.D. in nutritional sciences and is a physique coach, natural bodybuilder, and previous guest on The Drive. In the first half of this episode, Layne dives deep into the topic of energy balance, including the role that macronutrients and calories play in weight loss. He describes how many people struggle with tracking food and calories on their own across a variety of diets and how all of this can impact nutritional habits and behaviors. In the second half of the episode, Layne discusses the importance of protein and weightlifting for improving one’s body composition and increasing muscle mass. He explains how he would prescribe different training and nutrition programs for two hypothetical clients—a 50-year-old female who is entering menopause and wants to improve her health, and a 40-to-50-year-old male who wants to maximize muscle mass. Additionally, Layne discusses a number of supplements that could potentially benefit a training program including whey protein, branch chain amino acids, creatine, nitric oxide boosters, and more.
    We discuss:
    Defining energy balance and the role of calories [2:30]; Defining a calorie, whether they are all created equal, and how much energy you can extract from the food you eat [8:00]; Factors influencing total daily energy expenditure [12:15]: The challenge of tracking energy expenditure accurately, and the thermic effect of different macronutrients [23:30]; Challenges of sustained weight loss: metabolic adaptation, set points, and more [34:45]; Weight loss strategies: tracking calories, cheat meals, snacks, fasting, exercise, and more [40:45]; Sitting in discomfort, focusing on habits, and other lessons Layne learned as a natural bodybuilder [52:15]; Commonalities in people who maintain long-term weight-loss [1:01:15]; Does a ketogenic diet result in greater energy expenditure? [1:03:15]; The metabolic benefits of exercise, muscle mass, and protein intake [1:15:00]; The impact of lean muscle and strength on lifespan and healthspan [1:20:00]; Hypothetical case study #1: Training program for 50-year-old female [1:27:45]; Muscle protein synthesis in a trained athlete vs. untrained individual following a resistance training program [1:31:30]; Protein and amino acids needed to build and maintain muscle mass [1:37:15]; Nutrition plan for the hypothetical 50-year-old woman starting to build lean muscle [1:42:45]; Dispelling myths that excess protein intake increases cancer risk through elevations in mTOR and IGF [1:55:30]; Hypothetical case study #2: Training program for a 50-year-old, trained male wanting to increase muscle mass [2:04:00]; Maximizing hypertrophy while minimizing fatigue—is it necessary to train to muscular failure? [2:11:30]; Ideal sets and reps for the hypothetical 50-year-old male interested in hypertrophy [2:16:15];   Maximizing hypertrophy by working a muscle at a long muscle length [2:22:15]; Recommended lower body exercise routines and tips about training frequency [2:24:00]; Nutrition plan for the hypothetical 50-year old male wanting to add muscle [2:29:00]; Cycling weight gain and weight loss when building lean muscle mass, and expectations for progress over time [2:33:30]; Supplements to aid in hypertrophy training [2:38:30]; More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

    • 2 hrs 55 min
    Centenarians, metformin, and longevity | Nir Barzilai, M.D.

    Centenarians, metformin, and longevity | Nir Barzilai, M.D.

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    Nir Barzilai, Director of the Institute for Aging Research at the Albert Einstein College of Medicine, is back for his third appearance on The Drive. In this episode, Nir divulges insights into lifespan and healthspan through the lens of his extensive research on centenarians as well as the latest from the TAME trial (Targeting/Taming Aging with Metformin), a multi-center study investigating the concept that the multi-morbidities of aging can be delayed in humans. He discusses common gene variants found in centenarians, important pathways for longevity, and ultimately what we can learn from centenarians about extending lifespan while also trying to improve healthspan. Additionally, Nir goes into depth on metformin as a longevity tool for humans, including studies with positive and negative results. He discusses the impact metformin can have on exercise for both strength training and cardiovascular training, as well as future research facilitated by data from the TAME Trial. He also touches on epigenetic clocks and concludes with his take on the usefulness of NAD precursors as a potential gero-protective agent.
    We discuss:
    Insights from genetic studies of centenarians and twins [3:00]; Genes with protective variants that aid longevity [13:00]; The relationship between growth hormone and IGF-1 [22:45]; Use of growth hormone as a longevity tool [34:00]; Longevity genotypes: the role of APOE e2, Lp(a), Klotho, and CETP [41:45]; The correlation between high TSH and longevity [46:30]; Important pathways for longevity [52:00]; Insights from centenarian studies, nature vs. nurture, and more [59:00]; The contraction of morbidity that comes with improved healthspan [1:08:00]; Defining healthspan [1:13:13]; Unique perspectives and positive attitudes of centenarians [1:17:30]; Lessons to take away from centenarians [1:24:00]; Metformin overview: history, studies, and potential for gero-protection [1:28:45]; The TAME trial (Targeting Aging with Metformin) [1:39:00]; The challenge of studying metformin in animals models [1:46:45]; How data from the TAME trial could provide insights into biomarkers of aging and facilitate a future study on proteomics [1:53:30]; The search for biomarkers to identify who can benefit from treatment [2:00:30]; The impact of metformin on exercise, and finding the right indication for the use of metformin [2:10:30]; Are NAD precursors geroprotective? [2:21:30]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube
     

    • 2 hrs 29 min
    AMA #34: What Causes Heart Disease?

    AMA #34: What Causes Heart Disease?

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    In this “Ask Me Anything” (AMA) episode, Peter dives deep into the topic of atherosclerotic cardiovascular disease (ASCVD)—the number one killer in the developed world. Peter argues for the importance of paying attention to and understanding ASCVD given its ubiquity and inevitability. He goes into great detail about the development of atherosclerosis and how it can take hold at a very early age, the role of cholesterol, and the causal factors of ASCVD that determine prevention strategies. Additionally, he discusses the important metrics and biomarkers found in blood work, as well as diagnostic tests such as coronary artery calcium scores (CAC) and CT angiograms which help to determine the level of arterial damage present. Finally, Peter lays out the keys to understanding and interpreting calcium scores before wrapping up the conversation with his key takeaways regarding prevention.
    If you’re not a subscriber and listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or on our website at the AMA #34 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.
    We discuss:
    The importance of understanding atherosclerosis early in life [2:15]; Defining atherosclerotic cardiovascular disease (ASCVD), its causes, and the role of cholesterol [9:00]; The process of developing ASCVD, part 1 [15:00];  The process of developing ASCVD, part 2 [24:00]; The process of developing ASCVD, part 3 [32:45]; How early in life ASCVD can start to develop [40:30]; Case studies of atherosclerosis and figures showing real pathology [43:00]; Coronary artery lesions present in autopsies of different age groups [49:15]; The causal factors of ASCVD that determine prevention strategies [52:15]; Labs to identify biomarkers of ASCVD ]59:00]; Diagnostic tests to determine the level of arterial damage present—CAC, CTA, CIMT, and more [1:00:30] Keys to understanding and interpreting a CAC score and/or CTA results [1:05:15]; Is there a risk from cholesterol levels being too low? [1:13:00]; Key takeaways regarding prevention [1:15:45]; More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

    • 16 min
    Peter on nutrition, disease prevention, sleep, and more — looking back on the last 100 episodes

    Peter on nutrition, disease prevention, sleep, and more — looking back on the last 100 episodes

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    In this second edition of the “Strong Convictions, Loosely Held” episode, Peter discusses topics on which his thoughts have evolved as a result of his interviews with podcast guests and other information he’s gained since episode 100. Peter covers topics including cancer therapy and screening, as well as prevention strategies for cardiovascular disease and Alzheimer’s disease. He also describes changes in his perspectives on time-restricted feeding and protein consumption and on the therapeutic use of psychedelics, and he discusses some sleep supplements with remarkable efficacy. He ends with a special discussion on all things Formula 1 racing.
    We discuss:
    The concept of “strong convictions, loosely held” [3:10]; Update on Peter’s upcoming book [8:30]; Cancer: the promise of immunotherapy [14:15]; Cancer: how aggressive screening for gastrointestinal cancers could save lives [24:30]; Cardiovascular disease: how early and aggressive lowering of apoB could change the course of ASCVD [31:30]; Alzheimer’s disease: genes that modify risk associated with the APOE4 variant [40:15]; Time-restricted feeding: where the benefit comes from, and when this practice can be problematic [44:00]; The common problem of protein underconsumption [51:45]; The tremendous impact of exercise on lifespan and healthspan [54:45]; Peter’s shoulder surgery [1:00:15]; An uninspiring viewpoint on NAD precursors as a longevity tool [1:06:15]; Psychedelics: a powerful therapeutic tool in the right setting [1:09:30]; Sleep: updated thoughts on blue light and a remarkable drug for aiding sleep quality [1:13:15]; Book recommendation from Peter [1:20:45]; Formula 1: the 5 variables that determine the winner [1:22:00]; F1: the drivers [1:26:00]; F1: the tires [1:27:30]; F1: the engine and chassis [1:32:00]; F1: rule changes around cars [1:34:15]; F1: importance of qualifying races [1:41:15]; F1: racing strategy [1:47:30]; F1: season outlook and predictions [1:51:00]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

    • 1 hr 57 min

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